Examining Factors Influencing Length of Stay for Inpatients at Alcohol and Substance Addiction Treatment Center

Year 2024, Volume: 10 Issue: 1, 81 - 96, 28.03.2024

Oğuz Peker

https://doi.org/10.19127/mbsjohs.1428367

Abstract

Objective: The aim of this study is to determine the impact of impulsivity, treatment motivation, anxiety, and cognitive distortions on the duration of inpatient treatment for substance use.
Methods: The sample for the study consisted of 200 volunteer patients receiving inpatient treatment at the Alcohol and Substance Addiction Treatment Center. Participants underwent a general psychopathological evaluation using the Structured Clinical Interview for DSM-5 (SCID-5) administered by the clinician. All participants were given the Case Report Form prepared by the clinician along with the Barratt Impulsivity Scale-11 Short Form (BIS), Automatic Thoughts Scale (ATS), State and Trait Anxiety Inventory (STAI-I, STAI-II) and Treatment Motivation Questionnaire (TMQ).
Results: A significant distinction was noted in discharge statuses when comparing scores on the Barratt Impulsiveness Scale and nonplaning impulsiveness subscale, and the State and Trait Anxiety Inventory and Automatic Thoughts Scale. Those who were discharged with remission had notably lower scores compared to those who left voluntarily or were discharged due to rule violation (p< 0.001). Negative significant correlations were found between length of stay and Barratt Impulsiveness Scale and its subscales [BIS-T (p<0.001), BIS-NI (p<0.001), BD-MI (p=0.002), BD-AI (p<0.001)], State-Trait Anxiety Inventory (p<0.001), and Automatic Thoughts Scale (p<0.001) scores. Positive significant correlations were observed between duration of substance use and Barratt Impulsiveness Scale and its subscales [BIS-T (p<0.001), BIS-NI (p<0.001), BD-MI (p=0.003), BD-AI (p=0.021)], State-Trait Anxiety Inventory (p<0.001), and Automatic Thoughts Scale (p=0.035) scores.
Conclusion: This study demonstrates a relationship between the length of time spent in inpatient treatment, discharge outcomes, and certain substance use behaviors, impulsivity, automatic thoughts, and anxiety in substance abuse patients.

Keywords

Anxiety, Automatic Thought, Impulsivity, Motivation, Substance

References

• World Health Organization. (2001). The World Health Report 2001: Mental health: new understanding, new hope.
• United Nations World Drug Report (2023). https://www.unodc.org/res/WDR-2023/WDR23_Exsum_fin_DP.pdf
• Brorson HH, Arnevik EA, Rand-Hendriksen K, Duckert F. Drop-out from addiction treatment: a systematic review of risk factors. Clin Psychol Rev. 2013;33(8):1010–1024.
• Gvion Y, Apter A. Aggression, impulsivity, and suicide behavior: a review of the literatüre. Arch Suicide Res. 2011;15(2):93–112
• Moeller FG, Dougherty DM, Barratt ES, Schmitz JM, Swann AC, Grabowski J. The impact of impulsivity on cocaine use and retention in treatment. J Subst Abuse Treat. 2001;21(4):193-198.
• Hollander E, Evers M. New developments in impulsivity. Lancet. 2001;358(9286):949-950.
• Schreiber L, Grant JE, Odlaug BL. Emotion regulation and impulsivity in young adults. J Psychiatr Res. 2012;46(5):651–658.
• Miller L. Predicting relapse and recovery in alcoholism and addiction: neuropsychology, personality, and cognitive style. J Subst Abuse Treat. 1991;8(4):277–291.
• Conner BT, Longshore D, Anglin M. Modeling Attitude towards Drug Treament: The Role of Internal Motivation, External Pressure, and Dramatic Relief. Journal of Behavioral Health Services & Research. 2009;36:150-158.
• Ögel, K. Bağımlılık ve Tedavisi Temel Kitabı. 4.baskı. İstanbul: IQ Kültür Sanat Yayıncılık; 2021.
• Janowsky DS, Fawcett J, Meszaros K, Verheul R. Core heritable personality characteristics and relapse in alcoholics. Alcohol Clin Exp Res. 2001;25:94-98.
• Noone M, Dua J, Markham R. Stress cognitive factors, and coping resources as predictors of relapse in alcoholics. Addict Behav. 1999; 24(5):687-693.
• Evren C, Saatçioğlu Ö, Dalbudak E, Danışmant BS, Çakmak D, Ryan RM. Factorial structure and reliability and validity of Turkish version treatment motivation questionnaire (TMQ) in alcohol dependents. Journal of Dependence. 2006;7:117–122.
• Türkçapar H. Bilişsel Davranışçı Terapi Temel İlkler ve Uygulamalar. 12.baskı. İstanbul: Epsilon; 2018.
• Kouimtsidis C. Reynolds M, Drummond C, Davis P, Tarrier N. Cognitive-behavioural therapy in the treatment of addiction. Chichester, UK: John Wiley & Sons; 2007.
• Liese BS, Beck A. Cognitive- Behavioral Therapy of Addictive Disorders. New York: The Guilford Press; 2022.
• Mohamed I, Ahmad H, Hassaan S, Hassan S. Assessment of anxiety and depression among substance use disorder patients: a case-control study. Middle East Current Psychiatry. 2020;27(1):1-8.
• Brown RA, Evans DM, Miller IW, Burgess ES, Mueller TI. Cognitive behavioral treatment for depression in alcoholism. J Consult Clin Psych 1997; 65(5):715-726.
• Keil RM. Coping And Stress: A Conceptual Analysis. Journal of Advanced Nursing. 2004;45(6):659-665
• Sinha R. The role of stress in addiction relapse. Curr Psychiatry Rep. 2007;9(5):388-395.
• Elbir M, Alp Topbas O, Bayad S, Kocabas T, Topak OZ, Cetin, S, et al. Adaptation and Reliability of the Structured Clinical Interview for DSM-5 Disorders Clinician Version (SCID-5/CV) to the Turkish Language. Turkish Journal of Psychiatry. 2020.
• Öner N, LeCompte WA. State-Trait Anxiety Inventory: Manual. 2nd Edition. Istanbul: Bogazici University Publications; 1985.
• Tamam L, Güleç H, Karataş. Short Form of Barratt Impulsiveness Scale (BIS-11-SF) Turkish Adaptation Study. Archives of Neuropsychiatry. 2013;50(2):130–4.
• Şahin NH, Şahin N. Reliability and validity of the Turkish version of the automatic thoughts questionnaire. J Clin Psychol 1992;48(3): 334-40.
• Weiss NH. Tull MT, Viana AG, Anestis MD, Gratz KL. Impulsive Behaviors as an Emotion Regulation Strategy: Examining Associations between PTSD, Emotion Dysregulation, and Impulsive Behaviors among Substance Dependent Inpatients. Journal of anxiety disorders. 2012;26(3):453-458
• De Wit H, Richards JB, Dual determinants of drug use in humans: reward and impulsivity. 50th Nebraska Symposium on Motivation; March; University of Nebraska: Nebraska: 2002. p. 19-55
• Dom G. Hulstijn W. Sabbe B. Differences in impulsivity and sensation seeking between early-and late-onset alcoholics. Addictive Behaviors. 2006;31(2):298-308.
• Stark MJ. Dropping out of substance abuse treatment: A clinically oriented review. Clinical Psychology Review. 1992;12(1); 93-116.
• Hayatbakhsh MR, Najman JM, Jamrozik K, Mamun AA, Alati R, Bor W. Cannabis and anxiety and depression in young adults: a large prospective study. J Am Acad Child Adolesc Psychiatry 2007;46(3): 408-417.
• Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd, LL, et al. Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiologic Catchment Area (ECA) study. JAMA 1990;264(19):2511-2518.
• Hall, S. M. The abstinence phobias: Links between substance abuse and anxiety. International Journal of the Addictions. 1984;19(6):613-631.
• Andersson HW, Steinsbekk A, Walderhaug E, Otterholt E, Nordfjærn T. Predictors of dropout from inpatient substance use treatment: a prospective cohort study. Substance abuse: research and treatment. 2018;12:1-10
• O'Connor RM, Lopez-Vergara HI, Colder CR. Implicit cognition and substance use: the role of controlled and automatic processes in children. J Stud Alcohol Drugs 2012; 73: 134-143.
• Thylstrup B, Hesse M. Why run the risk? Motivation for offences by patients with substance use and antisocial personality disorders which they rated as most risky to their own well-being. Crim Behav Ment Health 2018; 28: 187-201.
• Yin HH, Knowlton BJ. Addiction and learning in the brain. In Wiers RW, Stacy AW (editors), Handbook of Implicit Cognition and Addiction. Thousand Oaks: Sage Publications, Inc, 2006:167-185.
• Charles-Walsh K, Upton DJ, Hester R. Examining the interaction between cognitive control and reward sensitivity in substance use dependence. Drug Alcohol Depend 2016; 166: 235-242.
• Yılmaz A, Can Y, Bozkurt M, Evren C. Alkol ve madde bağımlılığında remisyon ve depreşme. Psikiyatride Güncel Yaklaşımlar. 2014;6(3):243-256.
• Anton RF. What is craving? Models and implications for treatment. Alcohol Res Health. 1999;23(3):165-73.
• Bottlender M, Soyka M. Impact of craving on alcohol relapse during, and 12 months following, outpatient treatment. Alcohol and Alcoholism. 2004;39(4):357-361.
• Akkoyunlu S, Türkçapar MH. Bir teknik: Alternatif düşünce oluşturulması. Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi. 2013;2(1):53-59.
• Krampen G. Motivation in the treatment of alcoholism. Addict Behav. 1989;14(2):197–200.